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Wisconsin rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Facilitymedian $162 · 10th–90th $145$2950%50%10th90th$162Professionalmedian $126 · 10th–90th $76$2450%10%20%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $81.28 / $147.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $269.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $371.54 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $229.09 / $309.03
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $134.90 / $199.53
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $309.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $158.49 / $831.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $107.15 / $199.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $107.15
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $316.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $251.19 / $501.19
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $323.59 / $1,000.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $144.54 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $134.90